Dengue: Difference between revisions
No edit summary |
No edit summary |
||
| Line 17: | Line 17: | ||
**Inflate cuff to pressure b/w SBP & DBP, and leave for 5 min | **Inflate cuff to pressure b/w SBP & DBP, and leave for 5 min | ||
**(+) Test = 10-20 patechiae per square inch | **(+) Test = 10-20 patechiae per square inch | ||
==Differential Diagnosis== | |||
{{Template:Fever in Traveler DDX}} | |||
==Treatment== | ==Treatment== | ||
Revision as of 20:32, 26 March 2014
Background
- Aedes mosquito in urban area, especially during rainy seasons in tropical/subtropic regions (Asia, Africa, Central America, Caribbean)
- Most cases occur in SE Asia
- Dengue shock syndrome and hem fever rare in travelers
- Caused by second infection of different Dengue serotype
Diagnosis
- Clinical Diagnosis - High Fever + 'Breakbone' + GI sxs + Rash
- Incubate for 4- 7d, influenza like prodrome, fvr, HA, myalgia, LN, rash
- "Saddle back" fever
- high for several days, resolves for several days, then comes back for several days
- Labs: CBC: Leukopenia and thrombocytopenia
- CMP: LFTs elevated
- DIC labs should be sent
- Dx by 4x increase in acute/ conv titres - unlikely to be resulted in ED
- Tourniquet Test - Tests capillary fragility
- Inflate cuff to pressure b/w SBP & DBP, and leave for 5 min
- (+) Test = 10-20 patechiae per square inch
Differential Diagnosis
Fever in traveler
- Normal causes of acute fever!
- Malaria
- Dengue
- Leptospirosis
- Typhoid fever
- Typhus
- Viral hemorrhagic fevers
- Chikungunya
- Yellow fever
- Rift valley fever
- Q fever
- Amebiasis
- Zika virus
Treatment
- Supportive Care
- APAP for pain/fever
- DO NOT use ASA due to dz's hemorrhagic nature
- APAP for pain/fever
- IVFs
- Blood Component Transfusion - consider in hemorrhagic shock
Disposition
- Home - Well hydrated and non-toxic appearing
- Admit - High-risk pts (ie pregnant, elderly, children, chronic dz)
- ICU - pts with shock and end-organ damage